Recurrent Brief Depressive Disorder: Symptoms, Causes and Treatment

Depression is one of the most common types of disorders in the population and the ones best known about It can have a high degree of impact on the individual’s life, with both inactivity and high irritability.

Traditionally, a person was considered truly depressed if the depressive episode in question lasted more than 14 days. If this were not the case, the person usually did not receive a diagnosis for this disorder.

However, in recent years, there has been extensive research that, while it may still seem tentative, has indicated that true depression can occur in short bursts of time. These episodes are not a mild version of what has been called major depression, given that the degree of impact on the individual’s life can be such that they even commit suicide.

We are going to talk about a disorder whose duration has generated a wide debate: recurrent brief depressive disorder We will explain what it is, what its historical background is, what the WHO and the APA think about it, as well as differentiating it from other mood disorders.

What is recurrent brief depressive disorder?

Recurrent brief depressive disorder also called brief relapsing depression, is a psychological disorder characterized by intermittent depressive episodes. These episodes are not linked to the menstrual cycle in women, and have a short duration, between 2 and 14 days, with the usual duration being between 5 and 7 days. Episodes occur between 6 and 12 times a year. After a year, the sum of the days in which you have been depressed can add up to close to a month.

Although the episodes are short, The degree of depression reached is so serious that it can affect the person’s functionality, in addition to carrying out self-harm attempts and committing suicide. In addition, people who suffer from it often have anxiety and irritability.

Due to the characteristics of the disorder, it can be confused with major depression and other associated disorders, being differentiated not by the severity of the symptoms, but by the duration of the depressive episode.

Background of the diagnostic label

Since the 19th century, some disorders have been seen whose appearance occurs occasionally and for brief episodes, ranging from hours to days. In the past, these types of mood problems, especially if they appeared in the form of depression, were given various names such as ‘periodic melancholy’ or ‘intermittent depression’.

When the DSM-III (Diagnostic and Statistical Manual of Mental Disorders) was published, drawn up from a large body of psychiatric research, among the criteria for depression it was explicitly specified that the depressive episode should last more than two weeks. Thus, there was no diagnostic label that included the same symptoms of major depression but with a shorter duration.

Jules Angst, a Swiss psychiatrist, coined the term ‘brief recurrent depression’ in 1985 based on epidemiological data and proposed a series of criteria to diagnose this type of mood disorder. As a result of this, and thanks to several studies at the European level, the World Health Organization did include it in the tenth version of the ICD (International Classification of Diseases) in 1992, while the APA chose to offer provisional diagnostic criteria for this disorder in the fourth edition of the DSM.

Symptoms

Generally, people who suffer from recurrent brief depressive disorder suffer from the same symptoms as major depression. They present anxiety and irritability, in addition to manifesting hypersomnia

Depression, in general terms, is a symptom and set of disorders that can produce a high degree of deterioration in a person’s functioning and adaptation. In addition, the patients’ lives may be disturbed as a result of this, and the schedules and routines that the person may have acquired while not suffering from the episode may be altered.

Differential diagnosis

In the ICD-10 (), recurrent brief depressive disorder is defined as a disorder that meets the criteria for mild, moderate and severe depressive episodes. The peculiarity that makes this disorder different from major depression is that lasts less, with depressive episodes lasting less than two weeks

Thus, relapsing brief depression does not differ from major depression in the severity of symptoms, nor should it be seen as a mild form of this type of disorder. Depressive episodes, although brief, are particularly dangerous given the risk of the person committing suicide. This is why major depression and relapsing brief depressive disorder are considered two related but different disorders.

Also It differs from major depression with a seasonal pattern of recurrence due to the fact that depressive episodes in recurrent brief depressive disorder occur every month and are of shorter duration.

As for rapid cycling bipolar disorder, relapsing brief depression does not present hypomanic or manic episodes. As for premenstrual dysphoric disorder, it differs from it because it is not associated with the menstrual cycle.

It should be said that this disorder has a high comorbidity with anxiety disorders, such as generalized anxiety, in addition to being able to initiate the abusive consumption of certain substances and lead to an addiction.

Causes

The cause of recurrent brief depression is still unknown, and it is most likely a multi-causal phenomenon, with many variables influencing its appearance. However, it has been pointed out that There could be some kind of relationship between this disorder and bipolar in addition to being related to possible genetic factors.

It has been seen that a small group of patients diagnosed with this disorder present temporal lobe epilepsy.

Prevalence

Although at the moment research into this disorder has given rise to rather little data, it is estimated that about 5% of the population may suffer at some point in their life from an episode that meets the aforementioned characteristics. This frequency reaches 10% in young adults between the ages of 20 and 30

Treatment

People who are going through an episode of these characteristics can acquire a greater degree of well-being going to psychotherapy In this way, it is easier to adopt habits that weaken the presence of the disorder, until its effects fade or have much less power over people.

In addition, psychotropic drugs, specifically SSRIs, mood stabilizers, such as lithium, and antiepileptics, are prescribed in clinical practice. However, drugs alone do not make the disorder go away, and their goal is to mitigate symptoms in the medium term.